Acknowledgements This report has been prepared for The Murray Mallee LGA by URS and URPS. We gratefully acknowledge the assistance of the following members of the Steering Group:  Public Health Plan Steering Committee - Gary Brinkworth, Berri Barmera Council

- Jim Quinn, Coorong District Council

- Stephen Bateman, District Council of Loxton Waikerie

- Kevin Goldstone and Caroline Thomas, Mid Murray Council

- Katina Nikas, Renmark Paringa Council

- Clarry Fisher and Phil Eckert, Rural City of Murray Bridge

- Harc Wordsworth, Southern Mallee District Council (also representing District Council of Karoonda East Murray)

Cover photos courtesy of Paul White, Loxton Waikerie Council and Bianca Gazzola, Mid Murray Council

Contents

President’s Message 1 Executive Summary 2 1 Introduction 4 2 What determines Health and Wellbeing? 5 3 Legislative Context 6 South Australian Public Health Act 2011 Local Government Act 1999 4 Policy Context 7 South Australian Public Health Plan Other Strategies and Policies Specified by the Minister 5 The Murray and Mallee Local Government Region 8 6 Developing the Public Health Plan 9 7 Assessment of the State of Health 11 Factors that Influence Health Risks to Health Burden of Disease Summary of the State of Health Priorities for the Region 8 Audit of Existing Plans, Policies and Initiatives- Summary of Outcomes 19 Audit of existing initiatives (gaps and opportunities) Common themes for regional action 9 Strategies for Promoting Health 21 Stronger, Healthier Communities for all generations Increasing Opportunities for Healthy Living, Eating and Being Active Preparing for Climate Change Sustaining and Improving Public and Environmental Health 10 Implementation, Evaluation and Governance 35 11 Glossary 36 12 References 38 Appendices

Appendix A Policies Specified by the Minister Appendix B Audit of Plans, Policies and Initiatives Appendix C Audit of Council Plans Appendix D Regional Health Profile

President’s Message

Mayor David Burgess, President Murray and Mallee Local Government Association

Community is our great strength and nothing could We coordinate and facilitate the activities of local be more important than the health, wellbeing and government across the region to protect the safety of our citizens. I believe our region is a great environment, and promote economic and social place to live and has enormous potential for growth. development of the Murray and Mallee Region. To achieve this we must ensure that people can live Through this Plan we will work together to active, connected and productive lives so that we implement strategies that will promote the health can achieve our economic and social goals for the and wellbeing of our communities. We will continue future. to provide opportunities for citizens to be physically active and we will work with other agencies to Our Local Government Association was established prevent harm from alcohol and tobacco. to strengthen the representation of our region when dealing with other levels of government, private enterprise and the community.

Mayor David Burgess, President Murray and Mallee Local Government Association

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Executive Summary

This Regional Health Plan has been jointly prepared Councils can influence the health of their by the Councils that make up the Murray and Mallee communities in a myriad of ways, including the Local Government Association: provision of safe roads, footpaths, trails and cycle  Mid Murray Council tracks; provision of libraries and community  District Council of Karoonda East Murray facilities; health promotion; management of public  Southern Mallee District Council places and open space areas that support physical

 Renmark Paringa Council activity and social interaction.  Rural City of Murray Bridge The Councils of the Murray and Mallee region  District Council of Loxton Waikerie already contribute to the health and wellbeing of  Berri Barmera Council their communities across the four priority areas  Coorong District Council identified by the State Public Health Plan:

The purpose of the Regional Public Health Plan is to  Building stronger, healthier communities for all demonstrate how the Murray and Mallee LGA will generations. work to improve the health and wellbeing of the  Increasing opportunities for healthy living, community of the region over the next five years eating and being active. and is a legislative requirement of the South  Preparing for climate change. Australian Public Health Act 2011.  Sustaining and improving public and environmental health. The new approach to public health in South  Australia is captured in South Australia: A Better Regional Health Priorities Place to Live, the first State Public Health Plan launched in November 2013. The following priorities were established through

consultation with Council staff and an audit of The traditional scope of public health concerns have existing plans and strategies: been widened to recognise that the most challenging health issues facing our community are  Improving transport within the region and to no longer contagious diseases or those caused by and from the region. food contamination or borne by mosquitoes.  Improving access to and awareness of existing services. While these illnesses are still important, the leading causes of death in our community are  Support for an ageing community. cardiovascular disease, diabetes, cancer and  Stronger partnerships between State and Local respiratory illness. Government to improve access to resources.  Initiatives to assist in prevention and In addition, accidents and suicide are significant management of Type 2 Diabetes. causes of death with higher levels occurring in rural  Maintenance of existing levels of service. and regional communities.

Where and how people live play a strong part in their overall health and wellbeing. Local Governments play a leadership role in developing and sustaining strong communities.

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Strategies and Actions to Improve Health Outcomes The public health implications of climate change are considered in the new plan; particularly in relation to Section 9 of the Regional Public Health Plan sets out emergency response and recovery for more extreme strategies to promote health and highlights the weather events, supporting vulnerable members of actions which Councils will take and those which are the community in finding refuges on very hot days the primary responsibility of partner agencies. and in protecting public infrastructure from damage

that could create health risks.. Connections between members of the community and with services, support and the surrounding This plan reinforces Councils’ existing public and environment are enhanced by: environmental health programs and identifies the key partnerships that are required to sustain and  The design of the built environment to ensure improve their outcomes. that public spaces and footpaths provide safe access for people of all ages and abilities. Implementation, Evaluation and Governance  Community transport services that enable effective links. The processes for implementing the Plan will be  A strong network of volunteers. developed during 2014 with SA Health taking a lead

 Availability of community facilities and programs role in establishing partnership arrangements as such as libraries, community centres, youth identified in the Plan. recreation. Councils will be required to report on the progress  Information that is easy to obtain and made in implementing the plan to the Chief Public understand. Health Officer every 2 years. The first report will be  Recognition of the specific access needs of some due at the end of 2014. groups and individuals within the community, including people with disabilities, Aboriginal The Murray and Mallee LGA provides an

people and those for whom English is not their organisational structure to effectively co-ordinate first language. the implementation of the Regional Public Health Plan. Constituent Councils will identify the most appropriate way to resource this function. Good health outcomes are more likely when people are able to eat well and be physically active. Programs such as OPAL and the Healthy Communities Initiative have supported these contributors to better health. It is considered important that these, or similar initiatives, continue to be funded to build on existing achievements.

Smoking and drug and alcohol misuse are significant causes of disease and preventable deaths. Councils have limited influence in these areas, however they can play a leadership role in partnership with other agencies.

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1 Introduction

This Regional Public Health Plan has been jointly The Councils of the region will build upon the prepared by the Councils that make up the cooperative arrangements and resource sharing Murray and Mallee Local Government that already occurs. This plan identifies new Association: partnership arrangements with State and Federal agencies that will be necessary to address the  Mid Murray Council needs of their communities for the future.  District Council of Karoonda East Murray

 Southern Mallee District Council

 Renmark Paringa Council  Rural City of Murray Bridge  District Council of Loxton Waikerie

 Berri Barmera Council

 Coorong District Council

The Public Health Act identifies Local Councils as the local public health authority for their areas. This means Local Councils are in the best position to lead and co-ordinate public health planning for their communities. It does not mean that Local Councils are responsible for every issue affecting their community that has been identified in a plan.

The purpose of the Regional Public Health Plan is to demonstrate how the Murray and Mallee LGA will work to improve the health and wellbeing of the community of the region over the next five years and is a legislative requirement of the South Australian Public Health Act 2011.

The Regional Public Health Plan is guided by the South Australian Public Health Plan. It identifies the role that Councils already play in improving the health and wellbeing of the community and is a plan of action for the next five years.

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2 What determines Health and Wellbeing?

Local government plays a leadership role in community ‘Public health in the 21st century has a lot to do with building and is well placed to develop and implement the way our community is organised and how our society shares its benefits and advantages. It’s about local policies and actions to address health and the broad how we protect ourselves and how we rise to range of factors that influence health. This involves challenges and risks that threaten our communities, actions in a range of areas, including transport, roads, whether natural disasters, widespread diseases, or parks, waste management, land use planning, housing social or economic shocks that strain the very fabric and urban planning, recreation and cultural activities, of our communities. It reflects how resilient we are, health promotion and creating safe public places. For this how we recover from hardships and breakdowns, and how we can together rebuild and restore our sense of reason, it is important that the strategies to address wellbeing and community’ Public Health in Local Government are implemented - South Australia: A Better Place to Live 2013 across a wide range of council functions.

The illnesses that most challenge the health and wellbeing of our community are not the contagious diseases that have traditionally been the focus of Public Health. Today it is chronic diseases such as cardiovascular disease, respiratory disease, diabetes, and cancer that are the leading causes of death in our community.

The new approach to Public Health in South Australia widens the scope of public health concerns in local government. It recognises that the causes of chronic diseases can be influenced by a range of environmental, social and economic factors such as how we live, the Figure 1 Factors that determine Public Health environment we live in, our opportunities for education, Source: Ståhl et al. (2006, p. xxvi)38 employment, and how our community functions. These are known as the ‘social determinants of health’ shown in Figure 1. In other words, the health of a community is more than the sum of our individual lifestyle choices.

There is a strong relationship between people and place – where we live can determine our opportunities to be active, eat well, be socially engaged, have a job and feel safe.

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3 Legislative Context

South Australian Public Health Act, 2011 The Act creates a role for Councils to become the public health authorities for their region. Each Council must

The SA Public Health Act, 2011 (the Act) represents a new prepare a public health plan for either a single council approach to public health in South Australia. The Act aims region or, as in the case of this Plan, a group of Councils to preserve, protect and promote public health and may prepare a joint Regional Public Health Plan with the reduce the incidence of preventable illness, injury and agreement of the Minister for Health. The Act also disability in South Australia. The Act brings a new focus to provides for formal partnership agreements with state the range of social, economic and environmental and federal government agencies and non-government conditions which have a bearing on the health and organisations to become Public Health Partner Authorities we llbeing of a community. This Public Health Plan which assist councils to achieve their public health recognises the range of council activities that contribute objectives. to public health and wellbeing. Public health is influenced by how safe we feel, the opportunities we have to work, Local Government Act, 1999 study, participate in community life, undertake physical activity, and eat healthy food. Section 122 of the Local Government Act 1999 requires

Councils to prepare strategic management plans which The Act aims to encourage and assist people to live address amongst other things, the economic, social, healthier lives and to be well. It establishes eight physical and environmental development of the area, principles that guide the development of the Public Health partnerships with other Councils, and the role of Local Plan. Government in coordinating service delivery with State and national governments. The Act requires Public Health Plans to: The SA Public Health Act, 2011 makes provision for  Provide a comprehensive assessment of the state regional public health plans to be developed and adopted of public health in the region; in conjunction with Strategic Management Plans or  Identify existing and potential public health risks; incorporated into a Strategic Management Plan.  Develop strategies to address and eliminate or reduce those risks; and opportunities to promote public health in the region;  Address any public health issues, strategies, and policies specified by the Minister.

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4 Policy Context

Sout h Australian Public Health Plan Other Strategies and Policies specified by the Minister South Australia: a Better Place to Live Section 51(9)(a) of the South Australian Public Health Act 2011 requires regional health plans to address any public The vision for the draft South Australian Public Health health issues, strategies, and policies specified by the Plan (SAPHP) is: Minister. These plans are additional to the SAPHP and  Improving the wider determinants of health have been developed to address specific issues or and wellbeing and reducing health inequalities problems. They guide action between councils at a  Healthier choices made easier regional level and provide assistance to organisations  Enhancing health protection and recovery which may become Public Health Partner Authorities with strategies the M&MLGA: The Plan provides policy directions for both the State  South Australia’s Strategic Plan Government and Councils. It presents an overview of  State Government Strategic Priorities and the state of public health in South Australia a framework associated Action Plans, in particular: for the preparation of complimentary Public Health o Safe Communities Healthy Plans by Councils. Neighbourhoods o Every Chance for Every Child The aim of the SAPHP is to build the system and o Vibrant City networks that will support public health planning and  The Planning Strategy for South Australia: 30 Year Plan for Greater Adelaide and related Regional coordinated action into the future. The Plan establishes four priorities for action: Plans and policy library  Prospering in a Changing Climate: A Climate Change Adaptation Framework for South  Stronger and Healthier Communities and Australia, August 2012 Neighbourhoods for All Generations  Green Infrastructure Strategy  Increasing Opportunities for Healthy Living,  The People and Parks Strategy Healthy Eating and Being Active  South Australian Tobacco Control Strategy 2011- 2016  Preparing for Climate Change  South Australian Alcohol and Other Drug Strategy 2011-2016  Sustaining and Improving Public and  Aboriginal Health Care Plan Environmental Health Protection  Eat Well Be Active Strategy 2011-2016 Regional Public Health Plans should be consistent with  Chronic Disease Action Plan for South Australia the priorities of the South Australian Public Health Plan 2009-2012  and include information about issues identified in any South Australia’s Communities for All: Our Age Friendly Future plan, policy or strategy specified by the Minister or the  South Australia’s Oral Health Plan 2010-2017 South Australian Public Health Council (SAPHC). The

SAPHP establishes areas of action for councils in each area of priority and these are addressed in section 9 A summary of the key directions of each of these plans is below. set out in Appendix A.

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5 The Murray and Mallee Local Government Region

The Murray and Mallee Region covers a large area in The agricultural sector is the largest employer with a focus excess of 50,000 km2 taking in the areas from the on irrigated horticulture and broad acre cropping.

Riverland in the north, agriculture areas in the central, The strengths of the region identified by Council west, south and east along the Victorian border, and representatives include the natural environment, south westerly to the coast and lakes. Rural based especially the River Murray, the open spaces and communities throughout the area share a common quietness. Other strengths include housing affordability, interest in agriculture/horticulture, with towns primarily large back yards and a low cost of living. There was a servicing the farming and horticultural communities and consensus that a strong sense of community, feelings of supporting a growing tourism sector. belonging and quality of life are also advantages of living

The Murray River, and its associated wetlands and in the region. wildlife, Lake Bonney and a number of Some of the challenges include access to and retaining National/Conservation Parks, support a range of rare and existing health services, the ageing population and access endangered plant and animal species, and are major to services, insufficient transport services in the region, tourist attractions throughout parts of the Riverland and loss of younger people to the city, drug, alcohol and Mallee. Towards the coast, the Coorong National Park, mental health issues and ensuring the health of the River Lake Alexandrina and the shores of Lake Albert are well Murray remains a priority for the Government. known tourist attractions, particularly for recreational boating and fishing.

The Murray River travels from the north, and passing through seven of the member Councils, flows into Lake Alexandrina in the south. It supports a number of tourist and recreation activities, with a number of tourism vessels operating from centres along the river.

Photo courtesy of Paul White

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6 Developing the Public Health plan The development of this PHP is consistent with the requirements of s51 of the SA Public Health Act, 2011 using the actions described below and set out in figure 2. The development of the Plan included workshops with a range of staff at each of the member councils and two workshops with the Steering Group representing the region as a whole.

Figure 2 Process of developing the Public Health Plan

Assessment of the State of Health: Use of ABS and Audit of existing initiatives PHIDU data

The audit was undertaken using the audit tool developed for councils by SA Health. It uses the three lenses The Assessment of the State of Health for the Region draws upon public health data prepared for each council approach: SA Public Health Act, 2011 : SA Public Health by the Public Health Information Development Unit at the Plan : Assessment of the State of Health of the Region. University of Adelaide. It also uses the recently released This methodology is described in greater detail below. The Medicare Local: Country South SA 2013 Needs Assessment audit was undertaken of individual councils Strategic Report which covers a large part of the Murray and Mallee Management Plans, policies and initiatives listed in Region . The State of Health assessment was also informed Appendix B. A ‘traffic light’ system was used to rate the by workshops with each council that involved a range of actions of each council to identify areas of strength and staff from different areas of responsibility. opportunities to address the determinants of health. An audit was also taken at a regional level through a workshop with the steering group representatives from each council.

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Develop priority areas for action Identify implementation, evaluation and governance arrangements Priority areas for action were determined using the four key priority areas of the SAPHP. The areas for action were The M&MLGA will be responsible for overseeing the identified based on the assessment of the risks to health; implementation and reporting of the Public Health Plan. the gaps in existing council actions to protect and The retention of the Regional Health Plan Steering Group promote health, and also opportunities to use partnership (comprising professional representatives of each member arrangements to retain and strengthen some of the areas council) would perhaps be the best vehicle for this to of regional cooperation that are already working well. occur. In particular, there will be a need to liaise with SA Health to establish the partnerships with State and Identify partnership opportunities Federal Government agencies and non-government organisations that are identified as necessary to achieve There are a range of existing partnerships that provide some of the strategies and actions in section 9. Some of services and support to the community. These were these agencies have not yet formally become Public identified during the workshops with individual councils Health Partner Authorities as contemplated by the and the steering group representing the region as a legislation and the M&MLGA will report on progress in whole. The quality of existing partnerships was identified forming these partnerships at the end of 2014. as an issue that will require some attention as well as the need to establish new partnership arrangements to support health and wellbeing.

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7 Assessment of the State of Health

7.1 Factors that Influence Health

Population Profile:

The resident population in the region is shrinking, ageing This reduces the capacity of the community in a number 1 of ways, from the size of the workforce to the numbers of and showing declining socio-economic status . Population decline was not evenly distributed across the region as people available to play in sporting teams. Murray Bridge and Loxton both recorded increases in their Despite the overall decline in population, the rate of populations between 2006-2011 by 14% and 11% decline slowed during 2009 to 2011 which may be a respectively. There is a trend towards the smaller towns positive indicator of recovery in the region following the and the more rural areas losing population at a faster rate end of the drought. The indigenous population has grown than the region as a whole. at a higher rate than the non-indigenous population indicated by the larger increase in population of the The population of the Murray and Mallee LGA has a higher proportion of older people and children than the state indigenous Australians under the age of twenty. average. The loss of adults aged 20 to 35 years from the The region is comprised of a number of strong and region who move away for education and employment is resilient communities with higher than average numbers reflected in the smaller proportion of this age-group and is of volunteers and carers providing assistance to others. a trend also experienced by other rural areas of Australia.

Figure 3 Population Growth by Year 1

1 Medicare Local Country South SA, Interim Needs Assessment, 2013

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Figure 4 Unemployment Rate Figure 5 Workforce Participation Rate Socio-economic Status Employment

Socioeconomic status is an important determinant of The drought caused significant economic shock to the

health. Between 2006 and 2011 the region declined on region, particularly to those industries which relied on the national Index of Relative Socio-Economic irrigation. The impact led to a rise in unemployment and a Disadvantage (IRSD) from 954 to 942 (compared with 974 decline in workforce participation within the region. A for non-metropolitan Australia as a whole). In other number of businesses in irrigation industries closed words, relative disadvantage in the region has increased. resulting in job losses and flow-on economic impacts. The lowest scoring (most disadvantaged) Local Following the drought, local industry has undergone a Government Area within the region was Berri Barmera degree of restructuring which has widened the economic with a score of 895. base of the region to include a greater proportion of manufacturing and tourism. In the last two years, the unemployment rate has declined in contrast to state and national trends. At the same time, the average wage and

salary incomes have increased and follow state and national patterns of growth although the net average family income is persistently lower than state and national averages.

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44

Figure 6 Proportion of children living in welfare-dependent families

Education Early life and Childhood

The number of people with post-school qualifications Levels of immunisation in children across the region as a remains substantially lower than state and national whole are close to the average for non-metropolitan parts averages despite an increase in the proportion of people of the State. There is however significant variation within with post-school qualifications over the past decade. the region: The rate of immunisation one year of age was Attendance at high school was higher than state and highest in The Coorong (95.7%) and lowest in Murray national averages from years 8 to 11, however enrolments Bridge (88.9%). The rate of immunisation at five years of in Year 12 drop are significantly lower than state and age was highest in Mid-Murray (93.7%) and lowest in national averages. This may indicate people choosing to Berri-Barmera (82.2%). undertake trade training after completion of Year 11. Across the region there is a higher rate of children whose Young people in the region are either earning or learning mother has a lower educational attainment and children at similar levels to the rest of Non-metro South Australia, who live in welfare dependent families (Figure 6). indicating that even with lower participation rates during The data for childhood obesity at age 4 is not complete Year 12 indicating that young people are leaving school to across the region but indicates the rate in boys and girls is take up training and employment. above average. This is despite fruit consumption in children and adults meeting established targets.

The Australian Early Development Index identifies areas where children may be developmentally vulnerable on one or more domains. The parts of the region where children are most vulnerable are Murray Bridge, Mid Murray, Loxton Waikerie and Renmark Paringa Councils.

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Healthy Eating

Consumption of fruit (an indicator of healthy eating) is relatively high is consistent with non-metropolitan SA as a whole. Programs such as Healthy Murraylands and OPAL councils have encouraged healthy eating and appear to have achieved success in this area.

Mental Health

Mental health is identified as a serious issue in the region as use of community health services is higher than non -metropolitan SA as a whole. The rates vary across the region with Southern Mallee reporting usage rates double the non-metropolitan rate (Figure 7).

Premature mortality rates due to suicide are notably Figure 7 Clients of Community Mental Health Services higher in regional areas, and within the Murray and Mallee area are greater than within other areas in non-metropolitan South Australia. Participation rates in the CAMHS (Child and Figure 14 Clients of community mental health services

Adolescent Mental Health Services) are higher across the region when compared to non-metro SA and South Australia overall, highlighting the great need to address these issues affecting the mental health of children and young people in these rural areas.

Personal Health and Wellbeing

Self-assessed rates of fair or poor health are key indicators of health, wellbeing and quality of life. Figure 8 shows the distribution of fair or health. The region is above the state non-metropolitan average and Mid-Murray and Murray Bridge Councils have the Figure 8 Self Assessed Health greatest proportions of poor health. There is a broad correlation between poor health and socioeconomic disadvantage shown in the map on p.12.

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Community Connectedness and Personal and 7.2 Risks to Health Community Safety: The needs assessment for the region recently undertaken The strength and resilience of the community is by Medicare Local Country South made observations demonstrated by ninety percent of people in the about the more notable risk factors which include: region reporting they feel comfortable they could have support in times of crisis. Potentially preventable hospital admissions: While rather out-dated, the most recently available data The proportion of people gaining access to the internet at home in the last 12 months (70%) was (2005-07) show potentially avoidable hospitalisations at a rate of 4,035 per 100,000 in the Murray and Mallee region close to the rate for non-metropolitan SA (72%) as was community perceptions of safety while walking although the results are extremely varied across each alone in their local area after dark. council area. These are 18% above the South Australian average of 3,428 for the same period.

Avoidable hospitalisations represent a range of conditions for which admission to hospital should be avoided because

the disease or condition might have been prevented from occurring or because people needed to have access to timely and effective primary health care.

Middle and mature age health checks:

The region’s rate for 45-year-old health checks is approximately 61% of the rate across non-metropolitan Australia.

The wider region’s (including the South East) rates for annual health assessments by GPs for people aged 75 and over is 16,702 per 100,000, compared with 21,077 across non-metropolitan Australia. This is significantly lower, possibly reflecting the limited General Practice services and a lack of awareness of the benefits of regular health checks.

Concern about wind farms:

Some members of the community have raised concerns about the risk to physical and mental health from proposed wind farms in the region. At present however the scientific evidence does not does not positively link wind turbines with adverse health effects. The National Health and Medical Research Council will undertake an independent review of evidence in 2014 which may identify risks to health. The Murray and Mallee LGA will monitor the outcomes of this review.

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Figure 3 Burden of Disease Data, SA Health, unpublished 2013; Source: CSSAML

7.3 Burden of Disease Priority issues

Three disease categories: malignant neoplasms (cancer), Research undertaken by Medicare Local Country South cardiovascular diseases and mental and nervous system (telephone survey and focus groups among the general disorders were responsible for approximately half the public; online survey and face-to-face meetings among disability burden (DALY) in 2005-07, in both the region and service providers) indicated the greatest demand is for 1 South Australia as a whole2 : better access to mental health practitioners and specialists followed by better access to dental services. In line with State Average: The general public has also identified better access to general practitioner services as a need.  Cardiovascular disease and cancers account for over 60% of premature death in the region. Distance to health services was highlighted as a major  Mental disorders, nervous system and sense concern for people who may have to travel for hours to organ disorders and chronic respiratory disease access services, especially medical specialists and cancer together account for almost half of total deaths. treatment. Access to effective public transport to health services is limited and the research found some lack of 2 A comparison of the prevalence of disease shows the awareness of assisted transport schemes within the region region is over-represented in the following areas: among people who are eligible to use them.

Higher than State Average: This remoteness of most of the population has important implications for ensuring that health services are able to Unintentional injuries (road traffic accidents, falls, be delivered in rural settings. Medicare Local identifies the fire/burns/scalds, striking/crushing accidents and other importance of partnering with Local Government not only transport accidents) were almost double the rate for to improve the general population's health, but also to South Australia as a whole. The rates of Type 2 Diabetes improve awareness of and access to health services in the were also significantly higher. region.

2 One of the key measures associated with the burden of disease is the DALY (Disability Adjusted Life Year). One DALY is equal to one year of healthy life lost.

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7.4 Summary of Public Health Priorities for the Preparing for Climate Change Region The public health priorities involve anticipating and The key Public Health priorities for the region have responding to the risks from climate change which is been have been grouped under the State Public Health expected to lead to an increase in drought periods and the Plan priorities, they include: number of very hot days. Key risks include:

Stronger and Healthier Communities and  heat related illness and food contamination may Neighbourhoods for All Generations increase with the number of very hot days forecast  restrictions to potable water supplies in some The priority for the region involves maintaining and improving services to the region and overcoming the areas following periods of drought challenges for people living in remote areas. Key issues  wider economic impacts on industry including include: tourism   Support for an ageing community Sustaining and Improving Public and Environmental Health  Greater cooperation with State government Protection agencies to access resources The public health priorities for the region include:  Improving transport within the region and to and from the region  Reducing the risk of illness from infectious disease due to lower immunisation rates  Social and economic impacts of young people  leaving communities for education and Reducing the risk of mosquito-borne disease from employment. river flooding  Preventing loss of amenity from poor air quality  Improving access to services, including medical specialists  Preventing the risk of contamination and disease epidemics during natural disasters from poor sanitation

Increasing Opportunities for Healthy Living, Healthy  Protecting key public health infrastructure from a Eating and Being Active severe flood that could cause damage CWMS’ leading to contamination and outbreak of disease. A priority for the region is to reduce the prevalence of  Monitor research into the impacts of wind farms obesity in both adults and children. Maintaining and on human health and respond to any risks to building on programs such as OPAL and Healthy health that may be identified as a result of this Murraylands will be important to increase review. opportunities for physical activity and access to healthy food.

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8 Audit of Existing Plans, Policies and Initiatives- Summary of Outcomes

The review of council strategic documents highlighted the Areas that are adequately addressed considerable range of activities that councils already undertake to support the health and wellbeing of their Councils are active in traditional areas of environmental communities. The audit used a ‘traffic light’ system to rate health with immunisation, food surveillance and mosquito the actions of each council to identify areas of strength control programs. In the area of Preparing for Climate and opportunities to address the determinants of health. Change, most Councils have implemented water and The complete audit of council strategic documents is at energy efficiency measures. Volunteer programs to Appendix C. A summary of these findings is set out below: support community schemes that provide transport are an important contribution to the priority of Connected Areas that are well addressed Communities. There was a view that the involvement of volunteers could be expanded in the future. The audit showed councils were strongest in areas of their core functions – such as the provision of parks and Areas that need addressing gardens and sporting facilities. Councils have sought to become much more water efficient following the drought Areas of priority that should gain further attention include and are reusing treated wastewater to reduce reliance on the needs of vulnerable populations such as people for the Murray. Community transport is an area that all whom English is not their first language and Indigenous councils are currently addressing, despite this issue being communities. At this stage councils have not taken on raised as an area of unmet demand. additional responsibility for enforcement of smoking in outdoor areas and are unlikely to do so in during the short Councils are working to create safe neighbourhoods to medium term due to a lack of resources. Most Councils through the incorporate of CPTED principles in Council have implemented dry zones in certain public places but Development Plans. Council’s that have updated their have not focussed on the wider issue of drug use. This is Development Plans to the new Better Development Plan not a traditional area of council activity and so is likely to (BDP) standard were deemed to have addressed the require partnership arrangements with relevant agencies. CHESS1 principles for development. Protection of assets and infrastructure from extreme The role that Councils have played in OPAL programs and events associated with climate change was also noted as the Healthy Communities initiated addresses priorities an issue that may require further attention. Most around healthy eating and physical activity. As both of Council’s identified their involvement in the Zone these programs are funded by other spheres of Emergency Management Committee as important for Government, there is a risk that this funding will not be addressing Public Health in emergency and disaster renewed . There may be a need to identify alternative management planning. There will be a need to ensure funding sources for the successful elements of these that this is reflected in the Zone Emergency Management programs to ensure the communities continue to be Plan for the region which is currently being developed. supported to eat healthy food and to be physically active.

1 Other strengths include strategies to address the needs of Thompson S & McCue P 2008, The CHESS principles for older residents through the HACC program and the healthy environments: an holistic and strategic game plan for development of gopher routes to improve access for inter-sectoral policy and action, NSW Premier’s Council for Active Living, Sydney. people with limited mobility.

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9 Strategies for Promoting Health

Stronger and Healthier Communities and Neighbourhoods for All Generations

This section refers to programs that the councils in the Murray and Mallee Local Government Region are either jointly undertaking or are providing that promote community connectedness and resilience and address the needs of people at different life stages.

“This places a focus on how to make our communities more liveable, walkable, inclusive and accessible. It can be as straightforward as looking at ways of improving access to parks and playgrounds, improving

footpaths and street lighting, increasing cycle ways and improving transport plans generally. It can also include increasing opportunities for social connectedness, volunteering and other forms of community participation, as well as developing and implementing community safety strategies.” South Australia: A Better Place to Live 2013 What are Councils already doing across the region? Younger Citizens

Older Citizens Councils provide playgrounds and recreation spaces Presently the Home and Community Care (HACC) for young people. Councils have also identified the program provides the care, transport and nursing potential to coordinate the provision of large services to support vulnerable people to remain infrastructure such as playgrounds at a regional level living at home. The HACC program is funded by (particularly within the Riverland) to increase the Federal and State government agencies and also diversity of recreational opportunities. receives a contribution from councils in the region.

Community Passenger Networks (CPN) are funded People with Disabilities and their Carers through the (HACC) program and the Department of Planning Transport & Infrastructure (DPTI). The The Home and Community Care (HACC) program schemes provide transport to elderly citizens to and Community Passenger Networks also provide allow them to access hospitals, specialists and allied services and support for younger people with health. There are 3 community transport schemes operating in the Region: disabilities and their carers. These groups also have specific needs with respect to physical infrastructure  Murray Transport Connections which covers and the design of public spaces and community the Murray Bridge and Mid Murray Council facilities. Councils are responsible for ensuring that areas. their projects and developments undertaken by others meet legislated standards for disability  Murray Mallee Community Transport Scheme which covers the Coorong DC, Karoonda East access.

Murray DC & Southern Mallee DC. Indigenous Communities  Riverland Community Transport Scheme The Riverland Mallee Coorong Taskforce facilitates The needs of Aboriginal and Torres Strait Islander collaboration and service integration in the aged peoples with respect to disease prevention and care sector. The taskforce is also involved in improved management of health issues are well regional planning, data collection and advocacy in documented. Within the region there are two relation to aged care service reform. Aboriginal settlements that are managed by Other public amenities provided by council include Aboriginal Community Councils. The Gerard community is located in the Riverland development of accessible footpaths, shops, car parks, seating, shelter and shade. Most Councils Region and Raukkan is located on the Lower Murray also provide libraries and community facilities that adjacent to the Lower Lakes. support participation by older residents. The Coorong Council has a service agreement with the Raukkan Community Council.

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Migrant and Refugee Communities Climate Change Adaptation These communities can have specific issues related The climate change forecasts for South Australia to their ability to obtain information in their own suggest an increase in the number of days with language and cultural issues that restrict their ability extreme heat. Vulnerable community members to use some services e.g. availability of female include children and elderly. All councils provide health professionals. Some Councils in the region facilities such as libraries that can be used as refuges have established partnerships with migrant and on hot days. refugee services as well as with community-based ethnic organisations. On very hot days HACC programs make contact with

people who are identified as vulnerable to help Mental Health them plan for coping with high temperatures. The Councils play a significant role in promoting mental high costs of electricity can make some vulnerable health and wellbeing through creating environments households reluctant to use air conditioners. that are inclusive, welcoming and connected. The development and maintenance of public spaces, New houses are required to be energy efficient recreational facilities and community services all which will assist residents to adapt to the number contribute to environments that are supportive of hotter days as a consequence of climate change. mental health. Planning policy is particularly important as it can determine opportunities for Access to Education and Training social interaction and access to green spaces, both of which make a positive contribution to mental Councils in the Riverland support alternative health. Loxton-Waikerie and Renmark Councils also learning options and programs offered through offer free public Wi-Fi service at certain places which Flinders University Rural Clinical School, Riverland improves access to on-line access to mental health Learning Exchange, Riverland Innovative Community support and services. Action Networks (RICAN) and Operation Flinders (and the Chaffey Community Centre). The South Australian Government’s Suicide Use of Digital Technology Prevention Framework identifies a goal to “provide a sustainable, coordinated approach to service Regional Development Australia (RDA) Murraylands delivery, resources and information within is currently undertaking a project to increase the communities to prevent suicide”. The Frameworks access of health service providers and recipients in identifies a need for the development of Local the region to digital technology. The project team is Government Action Plans on suicide prevention working to improve access to health services and activities. The development of these plans will be a greater efficiency in existing services through the key response to the risks to mental health identified region to meet demand. for the region and will be led by State Government agencies in partnership with Councils.

Headspace is a national youth mental health foundation that provides a mental health service to young people aged 15-25 in the Murraylands sub- region. There is a Headspace centre in Murray Bridge.

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Strategies for Promoting Health

Public Health Strategies to promote health Actions by Councils Expected Outcomes: Role of Partner agencies Priorities: (draft) Building Stronger Healthier Communities for All Generations Building Community Incorporate the CHESS principles  Provide input to the Planning  All councils have completed  DPTI may incorporate CHESS connectedness through in planning policy to create Strategy update that addresses BDP conversions principles in updates to the the design of the built environments that are: these issues at a regional level Planning Strategy. environment and  Connected Incorporate CHESS principles  Evaluation of DPA’s will show provision of physical  Healthy eating into Development Plan incorporation of CHESS  LGA / PIA could provide infrastructure  Safe Amendments where appropriate principles professional development for  Sustainable  Planners and DAP members to planners on implementing undertake training on health  Planners and DAP members the CHESS principles into and planning when it is available have undertaken training in amendments to council Public spaces and footpaths  Ensure Council’s Disability health in planning Development Plans. provide access for people of all Action Plan is regularly reviewed ages and abilities and updated  Include accessibility as a key specification in all Council Works Projects and contracts – Council contracts and projects have accessibility specifications Building Community Support the needs of people of  Raise awareness in the  Increase in Community  Departments of Health and connectedness through different ages and abilities: Older community of the CPN – Transport passenger numbers Ageing, DCSI, DPTI are social infrastructure and people and people with Community Passenger Network  Increase in volunteer numbers requested maintain HACC community development disabilities  Facilitate greater use of  Customer satisfaction survey funding to the region. initiatives volunteer drivers by shows levels of service delivery coordinating and sharing are meeting demand. volunteers across councils  Continue to support programs and facilities that enable participation by older people

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Public Health Strategies to promote health Actions by Councils Expected Outcomes: Role of Partner agencies Priorities: (draft) Building Stronger Healthier Communities for All Generations

Support the needs of people of Increase availability of internet  Internet use at council facilities No partnership requirements different ages and abilities: access through Wi-Fi coverage and increases identified Younger people plug-in points in council libraries.  Number of computers available in council services increases

Councils to promote available school Number of schools offering after DECD may provide greater facilities for sports and recreation school facilities options for use of school facilities after hours Pursue greater opportunities for young people to be active in sport.

Recognise the specific health and  Build and strengthen Increased participation of Raukkan and Gerard Community participation issues affecting relationships with Aboriginal Aboriginal people and people from Councils and the Migrant Indigenous people and those for community leaders and migrant migrant communities in Council- Resource SA Centre and regional whom English is not their first organisations. led and promoted health initiatives migrant organisations may work language  Provide information in easy to with Councils to promote health read formats and in culturally in culturally appropriate ways. relevant ways.

Improved access to Reduce travel distance to major No actions required at this stage Mildura Base Hospital provides SA Health may investigate health services hospitals through access to services to the region partnership arrangement with services in Mildura which closer Victorian Government. than Adelaide hospitals for some patients.

Public Health Implications Ensure the community members Councils to distribute SA Councils distribute extreme heat No partnership requirements are of climate change are know how to respond to hot days government education materials and ‘fight the bite’ brochures to identified addressed and mosquito borne disease about extreme heat events to the the community. community

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Public Health Strategies to promote health Actions by Councils Expected Outcomes: Role of Partner agencies Priorities: (draft) Building Stronger Healthier Communities for All Generations Information distributed to the community about opportunities to use school facilities Mental health & The State Government’s Suicide Councils to cooperate with SA Councils are familiar with State SA Health and LGA could Suicide Prevention Prevention Framework is Health and LGA initiatives to Suicide Prevention framework coordinate a Suicide Prevention implemented using a regional develop a Suicide Prevention Plan action plan for the M&MLGA approach region in collaboration with Medicare Local

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Increasing Opportunities for Healthy Living, Eating and Being Active

This section focuses on the opportunities provided by Councils within the Murray and Mallee LGA for promoting healthy living, eating and physical activity within the community.

“Non-communicable conditions threaten our individual health and the productivity and vitality of our community. Overweight and obesity and low levels of physical activity are major risk factors for many non- communicable conditions (such as type 2 diabetes, stroke, ischaemic heart disease and certain forms of cancer) as well as contributing to overall mortality.” South Australia: A Better Place to Live 2013

What are Councils already doing across the region? Healthy Murraylands Program The Healthy Murraylands program aims to improve The five councils that make up the Murraylands: nutrition and increase physical activity participation Coorong District Council, District Council of within the region. Participating councils are Karoonda East Murray, Mid Murray Council, Rural increasing the rate of participation in exercise, City of Murray Bridge and Southern Mallee District recreation and sport. Council have a number of common features and programs to to promote physical activity and better Supporting Physical Activity nutrition. The River Murray in particular, is a In addition to these programs, all Councils provide unifying feature that provides opportunities for and maintain playgrounds, sporting facilities, recreation, physical activity and access to a natural footpaths and trails which support physical activity. environment that creates a sense of wellbeing. Each council creates access to the river through the Alcohol and Tobacco consumption provision of parks and reserves. These programs are Individual Councils have developed dry zones which central to the Council’s current actions to address prohibit public consumption of alcohol in certain the public health priority of Opportunities for riverbank areas to prevent problem drinking, Healthy Living, Eating and Being Active. violence and antisocial behaviour.

Mid-Murray Council was the recipient of the Healthy Community initiatives: National Heart Foundation Healthy Community Award 2013 for councils with populations of Healthy Murraylands (5 Murraylands councils) 15,000 or less. The award recognised initiatives such as the OPAL strategic plan, nutrition policies, River Life (Renmark Paringa Council) OPAL program councils: Healthy Lifestyle Policy, Community Bus Strategy  Mid-Murray and the introduction of community gyms within the community. These initiatives target the health  Coorong of the whole of the community with a focus of  Murray Bridge improving the lives of those most at risk of chronic OPAL communities are sharing facilities across all disease. council’s different council areas. Councils support the SA Government Office for Recreation and Sport STARCLUB Program which promotes clubs to be well managed.

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Strategies for Promoting Health

Public Health Priorities: Strategies to promote Actions by Councils Expected Outcomes: Role of Partner Agencies: health Increasing Opportunities for Healthy Living, Eating and Being Active Boosting opportunities for Maintain successful OPAL and Advocate for retention of OPAL Level of funding for OPAL and SA Health and LGA may physical activity and access to Healthy Communities programs funding or substitute funding for Healthy Communities program advocate for additional healthy food. sustaining key projects that activities is maintained or funding by State contribute to these goals replaced by other funding that Commonwealth targets these outcomes governments Open space and recreation Councils to review open space and Development of Tracks & DPTI and the Office of strategies focus on areas of recreation strategies Trails/Cycling/Walking Strategies Recreation and Sport can demand assist Councils to review and improve open space and recreation opportunities.

Promote Farmers’ markets to Support the establishment of farmers’ Maintaining the viability of PIRSA Food Group can increase access to fresh markets in the region farmers’ markets in the region promote regional produce authenticity in farmers’ markets

Councils provide leadership in Councils to develop Healthy Catering Council venues and events Heart Foundation could promoting healthy eating Policy for Council owned/operated implement a Healthy Catering provide guidelines to venues & events and host information Policy community groups on council websites for groups to use.

Reducing the prevalence of Smoking in public places is Councils to develop a Tobacco-Free Tobacco-Free policy applies on SA Health may establish smoking in the community discouraged Policy to apply on Council land & Council land and property partnerships with councils property to reduce harm from excessive alcohol and Note: at this stage Council’s do not tobacco use

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Public Health Priorities: Strategies to promote Actions by Councils Expected Outcomes: Role of Partner Agencies: health Increasing Opportunities for Healthy Living, Eating and Being Active have the capacity to issue expiation notices issued for smoking in public places

Reducing harm from alcohol Dry zones are implemented in Individual Council responses: dry-zone SAPOL statistics on nuisance An informal arrangement consumption public places areas behaviour in public areas show already exists between improvement. M&MLGA councils and SAPOL

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Preparing for Climate Change

This section focuses on the ways in which the Councils of the Murray and Mallee LGA provide for the community with extreme weather events and potential disasters related to changing weather and climate patterns.

“There is no doubt that climate change will have and is having implications for both the health of the public and public health infrastructure. There is also no doubt that climate change is an issue that warrants concerted efforts both across and between governments and from the whole community.

The inexorable longer term changes in climate mean, for example, that we need to plan and redesign our communities for warmer conditions, including better provision for shade and other cooling green infrastructure elements.” South Australia: A Better Place to Live 2013

What are Councils already doing across the region?

 Individual councils provide facilities and shade that serve as refuges from hot days  Councils have reviewed and updated inclement weather policies to establish a coordinated redirection of outdoor staff/volunteers to cool locations and/or to undertake alternative work. (As recommended by the LGA Climate Adaptation responses)  The Murray &Mallee Local Government Association Strategic Plan 2011 -2014 Social objectives identifies the need to develop an Integrated Regional Vulnerability Plan addressing: o Climate change o Changed river flows o Impacts on public and private infrastructure o Improve controls and funding for riverbank collapse and levee bank maintenance to reduce financial impact on local Councils and communities

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Strategies for Promoting Health

Public Health Priorities: Strategies to improve health Actions by Councils Expected Outcomes: Role of Partner Agencies (draft) Preparing for Climate Change Community resilience to Councils are prepared for Councils to determine their Development of a capacity LGA, DCSI and Commonwealth climate change climate change and have capacity to deliver emergency analysis for emergency agencies may partner with considered its public health response and recovery services response for extreme heat Councils to address identified implications for extreme heat events. and event (through the Vulnerability areas of need. partner with relevant Assessment Plan) authorities/agencies where appropriate (recommended by the LGA as Climate Adaptation responses for councils)

Council contractors and LGA standard contract is Local Government Association providers should ensure climate updated to require contractors could update its standard change is considered in their to address climate change risks contract to require contractors business planning and to address climate change risks. incorporated in strategies for vulnerable groups (as recommended by the LGA as Climate Adaptation responses for councils)

Promote libraries as places of Council communications Doctors and health services can refuge in extreme heat – cool promote libraries as refuges on promote libraries as refuges on place with cold water hot days. hot days.

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Public Health Priorities: Strategies to improve health Actions by Councils Expected Outcomes: Role of Partner Agencies (draft) Preparing for Climate Change Public Health infrastructure is Ensure the Integrated Completion of the SA Health could provide advice resilient to climate change and Vulnerability Assessment Plan Integrated Vulnerability to the M&MLGA during the extreme events for the region specifically Assessment Plan. development of the addresses public health Vulnerability Assessment Plan. infrastructure to ensure its continued functioning during an extreme event.

Plan for the economic impacts Support water reuse industries Provide input and support the Commonwealth grants support Regional Development of climate change on local throughout the region, with a recommendations of the SA industry restructuring Australia, Murray Darling Basin industry view toward primary MDB and NRM Boards. Commission, Natural Resource production and industry Management Board and the diversification and investigate Access grants from the Department of Environment options regarding regional or Strengthening Basin (Commonwealth) are potential subregional Water Communities program (see M & partners to achieve this Management Plans (see M & M M LGA Strategic Plan 2011 – strategy. LGA Strategic Plan 2011 – 2014). 2014).

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Sustaining and Improving Public and Environmental Health This section focuses on the ways in which the Councils of the Murray and Mallee service the community in terms of food safety, immunisation, communicable disease prevention and control, environmental factors and health, noise and air quality.

“Our communities function because of basic public health protection services and strategies. If they were absent or weakened, our health would be severely challenged due, for example, to the dangers of poor water quality, unsafe foods, ineffective waste disposal, falling immunisation rates and the spread of more virulent infectious diseases, poorly designed or unsafe dwellings, and inadequate community infrastructure.” South Australia: A Better Place to Live 2013

What are Councils already doing across the region?

 Individual councils respond to air quality complaints from the community  Provision of immunisation services  Coordination of food safety training  Mosquito Control Programs  Murray and Mallee Zone Emergency Management Plan (ZEMP) (draft 2012) provides a risk management framework to prevent and manage emergencies within the M&MLG region. The document is presently in draft form and does not yet identify public health risks.

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Strategies for Promoting Health Public Health Priorities: Strategies to improve health Actions by Councils Expected Outcomes: Role of Partner Authorities

Sustaining and Improving Public and Environmental Health Improving air quality in Identify sources of air pollution. Compliance with legislation Number of air quality EPA can work with Councils and specified locations complaints received by Councils business to reduce identified declines. sources of air pollution.

Retain and extend South Increase the rate of  Coordination and support Immunisation rates increase for SA Health can collaborate with Australia’s high rate of vaccine immunisation for children aged for immunisation services children aged 18 months to 5 the following organisations to uptake (see SA Public Health 18 months to 5 years in parts of  Letting people know years improve models for funding Plan) the region that are lower than services are available  DECD others  Australian Childhood Immunisation Register  Medicare Local

Improved models of service Regional models of service  Explore shared services A shared service agreement is SA Health and the LGA can work delivery across the Murray and delivery have a regional focus options where appropriate, in place between M&MLGA assist councils improve models Mallee Region. that is streamlined and take Riverland Councils to councils. of service delivery account of contemporary issues investigate shared service and technologies (see SA Public arrangements Health Plan)  Greater cooperation and resource sharing across the M&MLGA councils Lower the risks of mosquito- Mosquito numbers are Councils maintain mosquito Agreement between DEWNR DEWNR can advise Councils borne disease controlled to reduce the risk of controls and take additional and M&MLGA to share when flood plains are artificially infection action when floodplains are information about flooding. flooded artificially flooded– as this leads to increase in mosquito numbers

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Public Health Priorities: Strategies to improve health Actions by Councils Expected Outcomes: Role of Partner Authorities

Sustaining and Improving Public and Environmental Health Emergency Management and Public Health forms part of Provide input into the The completed ZEMP identifies LGA and SAFECOM can support Disaster Planning emergency and disaster development of the Zone public health risks and Zone Emergency Management management planning in the Emergency Management Plan measures to prevent and Committee to incorporate region. to identify public health risks manage these. public health in the Emergency relevant to the region and Management Plan for the treatments to address these. region.

Reducing death and illness Raise awareness of the dangers Councils to give consistent Business and the community EPA, SA Health and Safe Work resulting from asbestos-related associated with exposure to information about asbestos are provided with consistent SA can provide advice on diseases. asbestos fibres. management and removal to information about asbestos asbestos management and business and the community. management and removal. removal.

Swimming pool safety Improve safety of private Facilitate education, Improved compliance- provide DPTI Planning division can work swimming pools to meet enforcement and compliance of private swimming pools meet with Councils to support Swimming Pool Safety Swimming Pool Safety Building Code Australia improved compliance with the Regulations 2010. Regulations 2010 for swimming standards for safety. Swimming Pool Safety.

Safety in inland waterways Promote community Councils to provide distribute Councils distribute information SAFECOM (Water Safety awareness of the risks of inland information about safety in about water safety with Committee) can provide waterways and safety inland waterways. emphasis on inland waterways. information to councils for precautions when using rivers, distribution. lakes and dams.

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10 Implementation, Evaluation and Governance

10.1 Implementation 10.2 Evaluation

The processes for implementing the PHP will be The legislation requires Council’s to report on progress of developed during 2014 during which time SA Health and implementing the PHP to the Chief Public Health Officer the LGA will be working to build the capacity of councils, every 2 years. A report on the implementation of the PHP and other agencies to support the public health goals of should be provided to SA Health by the end of 2014. The local government. evaluation measures have been selected on the basis of the SMART principles: Specific; Measurable; Ambitious Contact Officer: A senior contact officer will be appointed and Achievable; Results-based and Time-bound. who will perform operational liaison functions with SA Health and the LGA and will be the principal point of 10.3 Governance contact with Public Health Partner Authorities. The Murray and Mallee LGA provides an organisational Regular meetings of the Steering Group: the Steering structure to effectively coordinate the implementation of Group will continue to meet on a regular basis to oversee the PHP at a regional level. The association has been the implementation of the PHP. There will be a role for established to carry out a coordinating, advocacy and managers of different areas of service delivery within representational role for its constituent councils across council to implement actions within their areas of the region. Its charter establishes a role to facilitate and responsibility. The Steering Group will be responsible for coordinate activities of local government at a regional preparing reports on the implementation of the PHP to level related to environment, economic and social the executive membership of the M&MLGA. This may development. This scope will allow it to address the range include assigning responsibility for across-Council of strategic priorities of the PHP. The purpose of the coordination to a senior manager. Association includes the development and management of policies which guide the conduct of programs and Integration into Strategic Management Plans: Individual projects in the region with the objective of securing the Councils will consider the most effective ways to integrate best outcomes for the communities in the region. this PHP into their Strategic Management Plans following the review of planning obligations contained in s.122 of In practice, each council has two representatives (usually the Local Government Act 1999. the Mayor and CEO) who attend the bi-monthly meetings of the M&MLGA. It will have oversight for the internal Development of Partnerships: SA Health will take a lead governance and coordination mechanisms required to role in establishing partnership arrangements with the ensure the implementation of the PHP across the State and Federal Government Agencies identified in the functions of Councils. action plan. This will be an ongoing process during 2014 as agencies formally take on the role of Public Health Partner Authorities and develop their capacities to respond to the needs of councils identified in PHP’s. Some of these agencies already have partnership arrangements with councils in the M&MLGA to provide services such as HACC funding, transport and disaster management which are identified in this PHP. In these cases, the existing partnerships will be strengthened by a more formal arrangement.

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11 Glossary

Affordable housing is housing that is appropriate to the needs of households with low and moderate incomes (i.e. up to 120% of gross annual median income). The indicative affordable house purchase price for these groups—currently $255,000—is determined by the affordability indicators gazetted on 8 October 2009 (p. 4,818) or as amended from time to time under the Development Act 1993 and South Australian Housing Trust (General) Regulations 1995

BDP refers to the Better Development Plan modules. This is the former name for the Department of Planning Transport and Infrastructure (DPTI)’s Planning Policy Library which contains a suite of ‘best practice’ planning policies for use by Council’s when updating their Development Plans.

CHESS Principles are principles for healthy environments, enabling professionals to work inter- sectorally and collaboratively to strategically devise policy and subsequent actions for wellbeing. These include Connected Environments, Healthy Eating Environments, Safe Environments and Sustainable Environments.

Climate Change refers to any significant change in the measures of climate lasting for an extended period of time. In other words, climate change includes major changes in temperature, precipitation, or wind patterns, among others, that occur over several decades or longer.

Connected Environments are places where basic needs are provided locally so it is easy and convenient to get prom place to place by using active transport. Additionally, Connected Environments may also refer to the connected ways of working through collaboration to achieve inter-sectoral planning design and implementation from the outset.

Development Plan is a statutory document that provides policies to assess development applications. For a council to ensure development outcomes are in accordance with its strategic management plan, the Development Plan must reflect the council's vision and complement the State's Planning Strategy.

Healthy Eating Environments are environments where there is a good choice of fresh food which is culturally appropriate, delicious and reasonably priced.

Local Government Authorities (LGA) LGA means the Local Government Association of South Australia;

Notifiable condition means a disease or medical condition that is a notifiable condition under Part 9;

Public Health means the health of individuals in the context of the wider health of the community.

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Safe Environments are the foundation of a healthy city. Community Safety audits and the use of ‘Crime Prevention Through Environmental Design’ are examples of this, used to ensure environments are safe and to encourage use of public areas.

Social support includes resources provided by other persons or ‘information leading the subject to believe that he is cared for and loved, is esteemed and valued, and belongs to a social network of communication and mutual obligation’. There is now substantial evidence to show that social support is beneficial to health and that social isolation leads to ill health. Social support has a positive effect on many different aspects of both physical and mental health; while ‘vulnerability factors’, such as lack of support, predispose a person to the development of ill health following a stressor such as an acute life event. Two types of mechanisms—direct effects and indirect (or ‘buffering’) effects—have been described for the action of social support on health.

Sustainable Environments are environments that facilitate growth and change over time and are ultimately supportive of good health.

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12 References

Berri Barmera Council 2011, Strategic and Corporate Plans 2011-2015, Berri Barmera Council, viewed 14 November 2013, .

Coorong District Council 2011, Community Needs Analysis, Coorong District Council.

Coorong District Council 2012, Strategic Management Plan 2012-2015, Coorong District Council, viewed 14 November 2013, .

Country Health SA 2011, Coorong 10 Year Local Health Service Plan 2011-2020, Government of South Australia: SA Health, viewed 11 November 2011, .

Country South SA Medicare Local Limited 2013, Medicare Local Country South SA: Interim Needs Assessment Summarised Report, South Australia.

Department of Planning and Local Government 2011, Murray and Mallee Region Plan; A Volume of the South Australian Planning Strategy, Government of South Australia, South Australia.

Department of Planning, Transport and Infrastructure 2011, The Planning Strategy for South Australia: Murray and Mallee Region Plan 2011, Government of South Australia, Adelaide.

Department of Regional Australia, Local Government, Arts and Sport 2013, myregion: Murraylands and Riverland, Australian Government, viewed 2nd October 2013, .

Department of Transport and Infrastructure 2010, The 30 Year Plan for Greater Adelaide, Government of South Australia, Adelaide.

District Council of Karoonda East Murray 2008, Strategic Plan 2008-2012, District Council of Karoonda East Murray, viewed 11 November 2013, .

District Council of Loxton Waikerie 2010, Strategic plan 2010-2015, District Council of Loxton Waikerie, viewed 7 November 2013, .

District Council of Loxton Waikerie 2008, Environmental health Management Plan 2008-2011, District Council of Loxton Waikerie, viewed 7 November 2013, .

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Drug and Alcohol Services South Australia 2011, Alcohol and Other Drug Strategy 2011-2016, Government of South Australia, Adelaide.

Drug and Alcohol Services South Australia 2011, Tobacco Control Strategy 2011-2016, Government of South Australia, Adelaide.

Government of South Australia 2011, South Australia’s Strategic Plan, Adelaide.

Mid Murray Council 2008, Strategic Management Plan 2006-2011, Mid Murray Council, viewed 7 November 2013, .

PIRSA Rural Communities 2009, Community Capacity Assessment: Loxton, Government of South Australia: Primary Industries and Resources SA.

PIRSA Rural Communities 2009, Community Capacity Assessment: Waikerie, Government of South Australia: Primary Industries and Resources SA.

Renmark Paringa Council 2009, Strategic Plan 2009-2014, Renmark Paringa Council, viewed 21 November 2013, .

Renmark Paringa Council 2012, Community Plan 2012-2016, Renmark Paringa Council, viewed 21 November 2013, .

Rural City of Murray Bridge 2012, Community Plan 2012-2020, Rural City of Murray Bridge, viewed 24 September 2013.

Rural City of Murray Bridge 2011, Strategic Management Plan, Rural City of Murray Bridge, viewed 24 October 2013, .

SA Health 2009, Chronic Disease Action Plan for South Australia 2009-2018, Government of South Australia, Adelaide.

SA Health 2010, Aboriginal Health Care Plan, Government of South Australia, Adelaide.

SA Health 2010, South Australia’s Oral Health Care Plan 2010-2017, Government of South Australia, Adelaide.

SA Health 2011, Eat Well Be Active Strategy 2011-2016, Government of South Australia, Adelaide.

SA Health 2012, Age Friendly Neighborhoods: Guidelines and Toolkit for Local Government, Government of South Australia, Adelaide.

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Southern Mallee District Council 2012, Strategic Plan 2012-2015, Southern Mallee District Council, viewed 21 November 2013, .

Thompson S & McCue P 2008, The CHESS principles for healthy environments: an holistic and strategic game plan for inter-sectoral policy and action, NSW Premier’s Council for Active Living, Sydney.

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